Kristin Clark - Rider
Winter Garden,FL
Summary
Experienced Medical Insurance Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering 10 years of experience and willingness to take on any challenge. Highly trained professional with a background in verifying insurance benefits and creating appropriate patient documentation. An established Insurance Verification Specialist known for handling various office tasks with undeniable ease.
Overview
11
11
years of professional experience
Work History
Senior Claims Adjustor
GEHA
Lee's Summit, MO
09.2011 - 06.2022
- Examined claims forms and other records to determine insurance coverage.
- Answered customer questions regarding deductibles.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
- Managed large volume of medical claims on daily basis.
- Paid or denied medical claims based upon established claims processing criteria.
- Responded to correspondence from insurance companies.
- Followed up on potentially fraudulent claims initiated by claims representatives.
- Checked documentation for accuracy and validity on updated systems.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Education
High School Diploma -
William Chrisman High School
Independence, MO05.2003
Skills
- Health Insurance Industry Knowledge
- New Policies Processing
- Eligibility Determinations
- Coverage Determination
- Patient Admission
- Healthcare Terminology
- Customer Satisfaction
- Data Entry Accuracy
- Accuracy Verification
- Document Scanning
- Insurance Claims Management
Timeline
Senior Claims Adjustor
GEHA
09.2011 - 06.2022
High School Diploma -
William Chrisman High School
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